93% of eligible clinicians received MIPS payment under QPP last year
Editor's Note New data from the Centers for Medicare & Medicaid Services (CMS) shows that 93% of eligible clinicians who participated in the Merit-Based Incentive Payment System (MIPS) under the Quality Payment Program (QPP) received positive payment adjustments for their performance last year, the November 9 EHR Intelligence reports. Only…
CMS gives states more Medicaid waiver power, and flexibility to lower premiums
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on October 22 issued guidance that gives state governors more power and flexibility in overhauling the rules and regulations of their Medicaid programs imposed by the Affordable Care Act and changes the way waivers are evaluated. Under the new policy,…
Early action advised to achieve better OAS CAHPS responses
Mandatory implementation of the Consumer Assessment of Healthcare Providers and Systems Outpatient and Ambulatory Surgery Survey (OAS CAHPS) originally scheduled for 2018 has been delayed, but that does not mean it should be ignored, say ambulatory surgery center (ASC) leaders. The earliest projected date when the survey could become mandatory…
CMS: 1,299 providers join new bundled payment initiative
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on October 9 announced that 1,299 healthcare providers are participating in its new Bundled Payments for Care Improvement−Advanced model, which began October 1 and will continue until December 31, 2023. The program includes 32 bundled clinical episodes (29 inpatient, 3…
CMS easing safety-net hospitals’ readmission penalties
Editor's Note The Centers for Medicare and Medicaid Services (CMS), on orders from Congress, is easing its annual readmission penalties on hospitals servicing low-income residents, the September 26 Kaiser Health News reports. The penalties are part of the Affordable Care Act’s effort to encourage better care. The sanctions have been…
CMS plans innovative new VBP models
Editor's Note The Centers for Medicare and Medicaid Services (CMS) will be unveiling new payment models centered on high-cost areas as part of ongoing efforts to advance value-based payment (VBP) care, and some models could be mandatory, the September 20 Healthcare Finance News reports. Healthcare providers can expect reduced regulatory…
Effect of Medicaid expansion on disparities in use of regionalized surgery at high-volume hospitals
Editor's Note The Affordable Care Act’s (ACA’s) Medicaid expansion had no effect on the utilization rates of regionalized surgery at high-volume hospitals (HVHs) overall or on disparities in vulnerable populations, this study finds. In this analysis of 166,558 adults at 468 hospitals who had one of four surgical procedures in…
Value-based payment models moving forward
Editor's Note Accountable care organizations (ACOs) and other value-based payment (VBP) models are increasing in the US, and there is no longer any question of whether private payers and the Centers for Medicare and Medicaid Services (CMS) will continue to support value-based payments, according to the August 14 Health Affairs…
Healthcare systems form own generic drug company
Editor's Note Seven healthcare systems representing 500 US hospitals are forming Civica Rx, a nonprofit company that will manufacturer generic drugs, in an effort to combat shortages and skyrocketing prices, cnbc.com reported September 6. The company, which is teaming up Intermountain Healthcare, the Mayo Clinic, HCA Healthcare, and four others,…
Effect of Medicare’s bundled payment program on volume, case mix
Editor's Note Hospital participation in Medicare’s Bundled Payments for Care Improvement (BPCI) program for lower extremity joint replacement (LEJR) was not associated with changes in overall procedural volume or the majority of patient case-mix factors, this study finds. The analysis of 1,717,243 Medicare patients found hospital participation in the BPCI…
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